Most mental health crisis services did not increase following 988 crisis hotline launch

Strategies needed to boost availability of crisis services at mental health treatment facilities

RAND Corporation

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The launch of the nation’s 988 mental health hotline did not coincide with significant and equitable growth in the availability of most crisis services, except for a small increase in peer support services, according to a new RAND study.

Examining reports from thousands of mental health treatment facilities about the types of crisis services offered before and after the July 2022 rollout of the 988 hotline, researchers found that there was an increase in peer support services, a significant decrease in psychiatric walk-in services, and small declines in mobile crisis response and suicide prevention services.

Significant variation across states was observed in service availability trends before and after 988. The findings are published in the journal JAMA Psychiatry.

“The lack of meaningful growth in most crisis services may limit the long-run success of 988, in particular if callers feel that reaching out to 988 fails to result in access to appropriate sources of care,” said Jonathan Cantor, lead author of the study and a policy researcher at RAND, a nonprofit research organization. 

“Mental health officials and policymakers should consider strategies to boost the financing and availability of crisis services at mental health treatment facilities to meet increased demand generated by the 988 Suicide and Crisis Lifeline,” Cantor said. 

The 988 Suicide and Crisis Lifeline provides an easy-to-remember phone number to access trained crisis counselors and emergency mental health services. It replaced the National Suicide Prevention Lifeline, which had been reachable via an 800 phone number and was narrowly focused on suicide as opposed to mental health crises more broadly. 

The 988 crisis line is intended to complement other forms of mental health emergency response services and connect callers with a variety of mental health services on the crisis care continuum.

However, mental health emergency response systems may not be amenable to rapid change despite increases in demand prompted by 988. In particular, the U.S. continues to contend with a shortage of psychiatric beds in many regions, as well as a limited and unevenly distributed mental health care workforce.

RAND researchers evaluated the availability of crisis services offered by mental health treatment facilities throughout the U.S. from November 2021 through June 2023.

Information came from details reported by licensed mental health treatment facilities to the Substance Abuse and Mental Health Services Administration. RAND has aggregated that data over time to create the longitudinal Mental health and Addiction Treatment Tracking Repository. The study included information from a large sample of reports from more than 15,000 mental health treatment facilities nationally.

The largest changes were observed for peer support services, which increased from being available at 39% of facilities prior to 988 to 42% afterward, and for availability of emergency psychiatric walk-in services, which declined from 32% to 29%.

The availability of other service types at mental health treatment facilities also declined at the national level. Mobile crisis response dropped from being provided by 22% of facilities before the rollout of 988 to being offered by 21% afterward. The availability of suicide prevention services dropped from 69% to 68% over the period.

There were also significant differences observed in crisis service availability based on facility characteristics. For example, public facilities had the highest odds of offering each of the four crisis services, followed by not-for-profit facilities. For-profit facilities, which comprised about one-quarter of the sample, consistently had the most-limited services.

State-level rates of suicide prevention services remained the same for most states over the study period. The largest increase in the availability of suicide prevention services was seen in Montana (11.5% increase), and the largest decline in availability was in Rhode Island (11.4% decrease). 

In contrast, most states experienced an increase in the number of facilities offering peer support services. The largest gain in offering of peer support services was in Kansas (19.6% increase) and the largest decline in peer support services was found in Georgia (3.2% decrease).  

Support for the study came from the National Institute of Mental Health. Other authors of the study are Megan S. Schuler, Rose Kerber and Ryan K. McBain, all of RAND, and Jonathan Purtle of New York University. 

RAND Health Care promotes healthier societies by improving health care systems in the United States and other countries.

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Journal

JAMA Psychiatry

DOI

10.1001/jamapsychiatry.2024.4548 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Changes in Specialty Crisis Services Offered Before and After the Launch of the 988 Suicide and Crisis Lifeline

Article Publication Date

29-Jan-2025

 

Discovery of a unique drainage and irrigation system that gave way to the “Neolithic Revolution” in the Amazon

Universitat Autonoma de Barcelona

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Ponds in the studied area.

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Credit: Author: Umberto Lombardo ICTA-UAB

A pre-Columbian society in the Amazon developed a sophisticated agricultural engineering system that allowed them to produce maize throughout the year, according to a recent discovery by a team of researchers from the Institute of Environmental Science and Technology (ICTA-UAB) and the Department of Prehistory at the Universitat Autònoma de Barcelona, (Spain); the Universities of Exeter, Nottingham, Oxford, Reading and Southampton (UK); the University of São Paulo (Brazil) and Bolivian collaborators. This finding contradicts previous theories that dismissed the possibility of intensive monoculture agriculture in the region.

The study, published today in the journal Nature, describes how the pre-Hispanic Casarabe society of the Llanos de Moxos in Bolivia designed and implemented an innovative landscape engineering system, including the construction of extensive drainage canals and farm ponds. This advancement allowed the transformation of flooded tropical savannahs into highly productive fields, thereby driving the development of the “Neolithic Revolution” in the Amazon, understood as the process towards an economy based on grain production.

This region, inhabited by the Casarabe people between 500 and 1400 A.D., is a tropical lowland savannah marked by intense rainy seasons and flooding, as well as very dry seasons. The discovery, led by Umberto Lombardo, an environmental archaeologist at the UAB, has identified a unique agricultural infrastructure previously undocumented anywhere else in the world.. This system enabled them to drain excess water from flooded fields during the rainy season, facilitating agricultural productivity. In addition to the drainage canals, the Casarabe people constructed clusters of farm ponds that served as water reservoirs. These ponds enabled pot-irrigation, allowing maize cultivation to continue throughout the dry season.

This dual water management system enabled at least two harvests of maize per year, ensuring a stable food supply year-round, which was essential for sustaining a relatively large population. "This intensive agricultural strategy indicates that maize was not only cultivated but was likely the staple crop of the Casarabe culture," explains Lombardo.

This agricultural model did not rely on traditional slash-and-burn techniques used to create fertile fields. Instead, the Casarabe people preserved nearby forests for other purposes, such as obtaining firewood and medicinal plants, while implementing practices that maximized the efficient use of water and soil in the seasonally flooded savannas.

These conclusions were made possible through meticulous fieldwork combining techniques such as microbotanical analysis, remote sensing, and environmental archaeology. The analysis of 178 phytolith (plant microfossils) and pollen samples from a farm pond confirmed the presence of maize in the fields and the crucial role of maize monoculture in the diet of this pre-Columbian society. "The data shows the absence of other types of crops," Lombardo adds.

"We can document that this is the first grain-based agrarian economy in the Amazon, where until now it was believed that agriculture was based on agroforestry polyculture and not on large-scale monocultures. Now we know that this was not the case in Llanos de Moxos", says Lombardo, who asserts that this innovative piece of engineering allowed for the transformation of a challenging environment into a productive system that ensured food stability and supported the development of a growing population.

The research not only sheds light on the technological capabilities of pre-Columbian civilizations but also offers valuable lessons for modern agricultural sustainability. This discovery is a testament to the ingenuity and adaptability of the Casarabe people, who thrived due to their ability to design long-term sustainable agricultural solutions in an adverse environment.

Photo of Umberto Lombardo in the field. 

Credit

Author Sergio Quezada, free to use.

Artwork of the ponds described in the paper. From the Extended data which are open access.

Credit

Author Julian Puig Guevara

Photo of ponds from airplane.

Credit

Author Umberto Lombardo

Journal

Nature

DOI

10.1038/s41586-024-08473-y 

Method of Research

Observational study

Article Title

Maize monoculture supported pre-Columbian urbanism in southwestern Amazonia

Article Publication Date

29-Jan-2025

 

Research contrasts drought sensitivity of Eurasian and North American grasslands

Findings have broad implications for land management practices on both continents

Colorado State University

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A test site in China

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Credit: Credit Colorado State University College of Natural Scie

Grasslands in Asia and North America differ in their responses to drought, according to a new paper in the journal Nature led by faculty at Colorado State University. The findings show that differences in the dominant grasses and lower species diversity in the Eurasian Steppe grasslands may make it more vulnerable to drought than the North American Great Plains.

The findings have broad implications for land management practices on both continents and provide a valuable comparison point that was not previously available when addressing climate change.

The work at CSU was led by Professors Melinda Smith and University Distinguished Professor Alan Knapp in the Department of Biology. Smith said the multi-year project was built through ongoing collaboration with researchers in China, including first author and Smith’s former postdoctoral researcher at CSU, Qiang Yu. Together, the team established six sites on each continent and imposed extreme drought conditions over a four-year period. They found the Eurasian grasslands saw a 43% reduction in annual productivity – plant growth each year – compared to just a 25% reduction in North America under the same conditions.

Smith said the findings also show that the negative effects of drought in Eurasia increased over time. Meanwhile, the North American system was able to stabilize in the second year of the experiment. The paper explores that difference, specifically considering how plant diversity impacted each region’s ability to cope with prolonged extreme droughts.

Smith said the research shows the difference may be linked to the overall number of uncommon, subordinate plant species in each region. These species make up the bulk of plant diversity there and contribute to overall productivity – even as primary species struggle to do so in drought conditions. The findings show these key subordinate species declined in Eurasian grasslands during drought conditions but increased in North America – potentially stabilizing production losses there over time. 

“Particularly in North America, we show that subordinate species seem to be minimizing losses and picking up the slack in a way that is not happening in Eurasia where there is less species richness,” she said. “These species’ ability to step up – possibly, due to drought tolerance developed over time – provides a unique perspective on these two vast grassland regions and how they function in these conditions.”

The two regions also support different types of dominant grass species. The Eurasian grasslands are primarily suited to supporting C3 grasses, like wheat, that prefer cooler and wetter conditions, while C4 grasses, like corn, flourish in the warmer American Midwest. That allows for interesting comparisons related to agriculture and management practices under drought conditions, said Knapp.

“In general, C4 plants have more efficient photosynthetic pathways and are more productive with less water than C3 plants. Such differences may be especially important when trying to understand how productivity will change with increasingly more severe droughts,” Knapp said.

Plant productivity is a fundamental component of the global carbon cycle. That is because plant photosynthesis is the primary way that atmospheric carbon, as carbon dioxide, enters ecosystems and is made available for consumption by animals and storage as biomass. Because grasslands cover 40% of the Earth’s surface, they play a large role in balancing and facilitating carbon uptake and sequestration globally.

Smith said understanding how these similar, yet differing biomes contribute to that process has proven difficult in the past. That is because researchers around the globe struggled to standardize experiments in a way that allowed for clear comparisons. This work directly addresses that need by developing a large-scale, coordinated, multi-year experiment at multiple sites. The 12 total test sites for the project are collectively known as the Extreme Drought Grasslands Experiment (EDGE) and were chosen because they represent a variety of grasslands located along precipitation gradients. 

Smith said the work shows how vulnerable regions with lower species diversity can be to prolonged droughts. It also shows the need for management strategies that increase and maintain plant diversity to enhance resistance to extreme drought events under future climate change scenarios.

“Dryer grassland tends to be where a lot of cattle grazing happens and where many people live globally. They are also important when we consider how carbon is stored related to climate change,” she said. “So, there is a real need to develop management strategies in these areas, as climate change is expected to increasingly impact them with extreme, prolonged droughts.”
 

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Journal

Nature

DOI

10.1038/s41586-024-08478-7 

Article Title

Contrasting drought sensitivity of Eurasian and North American grasslands

Article Publication Date

29-Jan-2025

 

Pairing old and new technologies could unlock advances in plankton science

University of Plymouth

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The Continuous Plankton Recorder device is towed in surface waters and occupies a similar space to a marine mammal. It has been used to monitor the oceans since 1931

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Credit: Marine Biological Association

Advances in technology – such as microscopic imaging and molecular techniques – have the potential to transform our understanding of global ocean health, according to the authors of a new study.

However, they should not be employed at the expense of long-term plankton monitoring programmes, which continue to provide an essential role in tracking how our seas are shifting in the face of a changing global climate and are essential for informing routine assessments of marine biodiversity required by  international law

Writing in the journal Ocean and Coastal Management, scientists say novel techniques do offer means of collecting and analysing select types of plankton data more efficiently than traditional methods.

They also have the potential to fill knowledge gaps and generate more complete pictures of plankton dynamics, factors which have led to them being proposed as possible alternatives to current monitoring programmes.

However, the authors say that the old and new methods come with different advantages and costs, while their uses and benefits – across marine management and scientific communities – can actually complement each other.

As such, they believe more effective ways should be found for old and new programmes to integrate with each other, combined with greater efforts to retain the specialist taxonomic skills needed to accurately assess plankton species and diversity.

The research was developed by some of Europe’s leading experts in plankton science, working at universities and government organisations in the UK, France, Sweden and the Netherlands.

Many of them are directly involved in long-term monitoring programmes that have been running for more than six decades, and the development of new monitoring technologies, as well as advising on the management of our ocean and seas.

Dr Matthew Holland, Research Fellow at the University of Plymouth and the study’s lead author, said: “Plankton support the entire marine food web and generate much of the oxygen we breathe. As such, we need to generate any information possible to ensure we know of changes in plankton communities and the impacts they could have on commercial fish stocks, sea birds, and the general health of the planet. There are amazing technologies coming on stream that can help with that – but existing monitoring has provided us with hugely valuable insights over the past six decades, and remains essential in tracking long-term changes in ocean health.”

The new study has been published at a time when there is growing global appreciation of plankton.

In September 2024, the Ocean Stewardship Coalition – an initiative of the UN Global Compact – launched a global Plankton Manifesto, which sought to emphasise the critical role of plankton in addressing the interlinked global crises of climate change, pollution, and biodiversity loss.

Dr Abigail McQuatters-Gollop, Associate Professor of Marine Conservation at the University of Plymouth and one of 30 international scientists to work on the Plankton Manifesto, is senior author on the new study. She added: “Plankton data are integral for understanding changes in our ocean. The new technologies being developed for monitoring plankton are exciting, but it is critical they are integrated with standard methods, many of which use a simple net and have been in place for over a century. They rely on people with years of experience in plankton science and research, and it is only through combining this human component with the monitoring methods that we can fully understand the implications of plankton change for marine ecosystems.“

Quotes from other co-authors

The study was written by researchers from: UK: University of Plymouth; Plymouth Marine Laboratory (PML); Environment Agency; Marine Directorate of the Scottish Government; Centre for Environment, Fisheries and Aquaculture Science (Cefas); Marine Biological Association (MBA); Tiny Ocean Health Insights Ltd; Scottish Association for Marine Science. France: Centre National de la Recherche Scientifique. Sweden: Swedish Meteorological and Hydrological Institute (SMHI). Netherlands: Directorate General for Public Works and Water Management.

Professor Angus Atkinson MBE, Senior Marine Ecologist at Plymouth Marine Laboratory: "The decline in skilled taxonomists is a worldwide concern, in both terrestrial and aquatic ecology. This paper makes the important point that these undervalued skills need to be retained, since the transition towards new technology actually increases, rather than decreases, the need for taxonomy.”

Dr Karen Tait, Microbial Ecologist at Plymouth Marine Laboratory: “Molecular techniques can provide valuable insight into plankton that are hard to identify without specialist knowledge, are difficult to sample or are rare. Yet, there is still a great deal of uncertainty over how molecular could and should be interpreted. This paper highlights the need for proof-of-concept studies that provide a thorough comparison of data provided by microscope-based methods with that provided by newer technologies.”

Dr Callum Whyte, a phytoplankton ecologist at the Scottish Association for Marine Science, said: “This paper is a review of the current methods used to monitor plankton around Europe, including methods such as the Imaging-Flow CytoBot (IFCB), which SAMS and UHI Shetland have deployed off a fish farm in Shetland. We make the case that while these new methods are useful and exciting they are a long way from replacing the ‘gold standard’ methods that we currently employ. That said, the paper also highlights the decline in trained plankton taxonomists and urges policy makers to address this through added, targeted funding.”

Enabling continued excellence in plankton science

As part of the study, the authors make a series of recommendations which they believe will enable the scientific community to embrace novel technology, while also ensuring the continuity of standard monitoring time-series. They include:

• Gradual integration and intercalibration: We need to conduct parallel studies which apply novel methods alongside standard plankton monitoring to calibrate, align and verify novel data types against standard microscopy methods to ensure compatibility, consistency, and reliability.
• Rethink how we value and employ taxonomists: The need for skilled taxonomists is increasing, rather than declining, since their skills underpin an expanding suite of sampling methods. We need a much wider realisation of this taxonomic need, at all levels spanning from funder to that of individual institutes.
• Incentivise open data practices: Make data from both standard and novel methods more readily available for public use.
• Improve communication: The message that long-term time series are valuable for climate change research is still not fully recognised, and we need to better communicate the value of long-term science to policymakers, funders and the public, as well as establishing a better understanding of the true costs and benefits involved with the various standard and novel methods.
• Streamline/reprioritise standardised methods: We need to establish standardised data collection and analysis protocols that integrate standard and novel methods to ensure time-series remain comparable across sites and over time.

Novel plankton monitoring technologies  

Four examples of instruments currently used for automated imaging methods in plankton monitoring:

• A - The Plankton Imager (Pi-10; Plankton Analytics), consists of a high-speed camera that images all passing particles in a flow of pumped seawater. Images are identified in real-time and uploaded via satellite.
• B - The ZooSCAN (Hydroptic) uses a flatbed scanner with specialised lighting and a watertight scanning chamber to record high-resolution images of zooplankton samples.
• C - The Imaging FlowCytobot (McLane Labs) is an automated submersible imaging flow cytometer that captures high-resolution images of particles (triggered by fluorescence) in situ.
• D - FlowCam is a flow imaging microscope that captures high-resolution images of microscopic particles as they pass through a flow chamber.

Credit

University of Plymouth

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Journal

Ocean & Coastal Management

DOI

10.1016/j.ocecoaman.2025.107542 

Method of Research

Literature review

Subject of Research

Not applicable

Article Title

Mind the gap - the need to integrate novel plankton methods alongside ongoing long-term monitoring

Article Publication Date

29-Jan-2025